脑桥出血后听力丧失及四肢瘫痪1例

A case of hearing loss and quadriplegia after a pontine hemorrhage

We herein describe the case of a 50- year-old female who developed a pontine hemorrhage with consciousness disturbance and quadriplegia. Her respiratory condition was so bad that she needed to be intubated and put on artificial respiration. After her consciousness and respiratory condition gradually recovered, we noticed that she had developed a bilateral hearing loss. The auditory brain stem response test revealed only I waves on both sides, thus suggesting that her hearing loss had been caused by an injury to the hearing-conducting pathway including the cochlear nuclei. In this case, the hematoma extended from the lower to the upper part of pons and, furthermore, it was also located broadly in the dorsal part of the pons. As a result, the cochlear nuclei and corpus trapezoideum appeared to have been destroyed by the hematoma. However, since most cases with a brain stem hemorrhage showing bilateral hearing loss tend to be in a severe condition, this condition is often easy to overlook. We should therefore carefully evaluate patients’ reaction to hearing stimulation to avoid overlooking any hearing loss in such patients.

We herein describe the case of a developed a pontine hemorrhage 50 -year-old female who with consciousness disturbance and quadriplegia. Her respiratory condition was so bad that she needed to be intubated and put on artificial respiration. After her consciousness and respiratory condition gradually recovered, we noticed that she had developed a bilateral hearing loss. The auditory brain stem response test revealed only I waves on both sides, thus suggesting that her hearing loss had been caused by an injury to the heating-conducting pathway including the cochlear nuclei. In this case, the hematoma extended from the lower to the upper part of pons and, furthermore, it was also located broadly in the dorsal part of the pons. As a result, the cochlear nuclei and corpus trapezoideum appeared to have been destroyed by the hematoma. However, since most cases with a brain stem hemorrhage showing bilateral hearing loss tend to be in a severe condition, this condition is often easy to overlook. We should therefore carefully evaluate patients＇ reaction to hearing stimulation to avoid overlooking any heating loss in such patients.